The Impact of Culture Medium on Morphokinetics of Cleavage Stage Embryos: An Observational Study

Linette van Duijn, Melek Rousian, Charlotte S. Kramer, Eva S. van Marion, Sten P. Willemsen, Jeroen P. Speksnijder, Joop S.E. Laven, Régine P.M. Steegers-Theunissen, Esther B. Baart*

*Corresponding author for this work

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Abstract

To study the impact of culture media on preimplantation morphokinetics used for predicting clinical outcomes. All IVF and ICSI cycles performed between 2012 and 2017 with time-lapse information available were included. In November 2014, culture medium was changed from Vitrolife G-1 PLUS to SAGE 1-Step. Each embryo was retrospectively assigned a morphokinetic-based KIDScore for prediction of implantation. Clinical outcomes were retrieved from medical records. Linear mixed models were used to study differences in morphokinetic parameters, a proportional odds model for KIDScore ranking and logistic regression for differences in clinical outcomes. All analyses were adjusted for patient and treatment characteristics. In 253 (63.1%) cycles, embryos (n = 671) were cultured in Vitrolife, and in 148 (36.9%) cycles, embryos (n = 517) were cultured in SAGE. All cleavage divisions occurred earlier for SAGE embryos than for Vitrolife embryos (2-cell: -2.28 (95%CI: -3.66, -0.89), 3-cell: -2.34 (95%CI: -4.00, -0.64), 4-cell: -2.41 (95%CI: -4.11, -0.71), 5-cell: -2.54 (95%CI: -4.90, -0.18), 6-cell: -3.58 (95%CI: -6.08, -1.08), 7-cell: -5.62 (95%CI: -8.80, -2.45) and 8-cell: -5.32 (95%CI: -9.21, -1.42) hours, respectively). Significantly more embryos cultured in SAGE classified for the highest KIDScore compared to embryos cultured in Vitrolife (p < 0.001). No differences were observed in clinical outcomes. Our results demonstrate an impact of culture medium on preimplantation embryo developmental kinetics, which affects classification within the KIDScore algorithm, while pregnancy outcomes were comparable between the groups. This study underscores the need to include the type of culture medium in the development of morphokinetic-based embryo selection tools.

Original languageEnglish
Pages (from-to)2179-2189
Number of pages11
JournalReproductive Sciences
Volume29
Issue number8
DOIs
Publication statusPublished - Aug 2022

Bibliographical note

Funding Information:
This research was funded by the Department of Obstetrics and Gynecology of the Erasmus MC, University Medical Center, Rotterdam, the Netherlands, the Netherlands Organization for Health Research and Development (ZonMW, project number 209040003) and the Erasmus MC Medical Research Advisor Committee’s ‘Health Care Efficiency Research’ programme (2016).

Publisher Copyright: © 2022, The Author(s).

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